Healthy
Conditions
Keywords
Safety
Brief summary
Phase I double blinded randomized trial of the safety and tolerability of Lactobacillus reuteri DSM 17938 given for five successive days in healthy children. Sixty children will receive study product at a treatment to placebo ratio of 2:1 and followed for 3 months for safety outcomes.
Detailed description
The study is a single center Phase 1 double blind placebo controlled trial of Lactobacillus reuteri DSM 17938 in children aged 2-24 months. The study population is based in a community with a registered clinical trial center in rural Peru where this protocol can be done in a highly controlled setting. The study is intended to enroll healthy children living in a resource constrained setting where chronic undernutrition and diarrheal disease is common, as this is the population that is most likely to receive benefit from the use of this and or other probiotic products for the treatment of acute infectious diarrhea and environmental enteropathy. Up to 100 subjects will be enrolled in order to obtain the randomization of 60 subjects, who will receive study product or placebo at a ratio of 2:1. Participants will be enrolled between the ages of 8 weeks and 24 months. There will be no age stratification. Participants will be screened with a baseline history and physical examination and laboratory tests to determine the HIV status of the child, as well baseline laboratory tests to evaluate occult infections, hepatic function, and renal function. Upon randomization subjects will be screened and randomized to a treatment arm. Product will be administered under the direct supervision of study staff daily for 5 days. The primary outcome is the safety and tolerability of the product at this dose and formulation. Safety will be assessed by the monitoring of baseline laboratory tests at 5 and 28 days following the initiation of therapy and by AE monitoring. Tolerability will be evaluated by analyzing 28 day diary cards that are distributed to all randomized subjects on which parents record their child's symptoms (specifically fever, anorexia/oral intake, vomiting, diarrhea, irritability, rash, wheezing, or open fields which allows them to describe any issue their child may experience and grade its severity) . Secondary outcomes include: 1\) The assessment of the duration of shedding of Lactobacillus reuteri (Lr) strain DSM 17938 following administration. This will be determined by and endpoint PCR assay for L. reuteri done on stool collected on D3, D5, D12, D15, D18, D24, D28, D36 on all participants. The planned enrollment period is four months and the participation of individual subjects is for 3 months. The study should be completed in 7 months. Safety monitoring by treatment group, i.e., infants assigned to active or placebo study product will be conducted by NIDDK appointed DSMB under the direction of the NIDDK Program Official.
Interventions
probiotic
Composition Sunflower oil, medium chain triglyceride oil and silicon dioxide. Total viable count of L. reuteri is zero CFU/ 5 drops.
Sponsors
Study design
Eligibility
Inclusion criteria
* In order to be eligible to participate in this study, a subject must meet all of the following criteria: * Have a parental permission form signed by both parents * Be between 8 weeks to 24 months of age with no preexisting
Exclusion criteria
* Have parents who are willing to comply with all planned study procedures and be available for planned study visits for 3 months.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With Positive Blood Culture for L. Reuteri | Participants are followed for an average of 36 days | number of participants with positive blood culture for L. reuteri |
| Mean Daily Temperature | 5 days of study product administration | — |
Countries
Peru
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Lactobacillus Active Product: Description Lactobacillus reuteri 17938 suspended in sunflower oil, medium chain triglyceride oil, silicone dioxide. Total viable count of L. reuteri 17938 1 x 108 CFU/5 drops.
Lactobacillus reuteri 17938: probiotic | 40 |
| Placebo Composition Sunflower oil, medium chain triglyceride oil and silicon dioxide. Total viable count of L. reuteri is zero CFU/ 5 drops.
Placebo: Composition Sunflower oil, medium chain triglyceride oil and silicon dioxide. Total viable count of L. reuteri is zero CFU/ 5 drops. | 20 |
| Total | 60 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Lost to Follow-up | 1 | 0 |
Baseline characteristics
| Characteristic | Lactobacillus | Placebo | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 40 Participants | 20 Participants | 60 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Continuous | 10.5 months STANDARD_DEVIATION 5.8 | 11.9 months STANDARD_DEVIATION 5.2 | 10.9 months STANDARD_DEVIATION 5.6 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 40 Participants | 20 Participants | 60 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 0 Participants | 0 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Region of Enrollment Peru | 40 participants | 20 participants | 60 participants |
| Sex: Female, Male Female | 17 Participants | 12 Participants | 29 Participants |
| Sex: Female, Male Male | 23 Participants | 8 Participants | 31 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 40 | 0 / 20 |
| other Total, other adverse events | 28 / 40 | 16 / 20 |
| serious Total, serious adverse events | 0 / 40 | 0 / 20 |
Outcome results
Mean Daily Temperature
Time frame: 5 days of study product administration
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Lactobacillus | Mean Daily Temperature | 36.5 degrees Centigrade/day | Standard Deviation 0.23 |
| Placebo | Mean Daily Temperature | 36.5 degrees Centigrade/day | Standard Deviation 0.23 |
Number of Participants With Positive Blood Culture for L. Reuteri
number of participants with positive blood culture for L. reuteri
Time frame: Participants are followed for an average of 36 days
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Lactobacillus | Number of Participants With Positive Blood Culture for L. Reuteri | 0 Participants |
| Placebo | Number of Participants With Positive Blood Culture for L. Reuteri | 0 Participants |